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Year 3: Block 1: Medical Ethics > Mental health legislation > Flashcards

Mental health legislation Flashcards

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USMLE® Step 1 flashcards
1
Q

involuntary treatment for mental illness?

A

Treatment of a small group of patients, those who are:
1 - severely unwell, psychotic
2 - Risk to self or others

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2
Q

Mental heath legislation provides a

A

legal mechanism to authorise treatment for patients that would otherwise fall into other categories

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3
Q

Involuntary treatment - general criticisms?

A

ill-liberal
May not be compatible with the international rights
unnecessary for most patients
practical problems in administering

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4
Q

Name some international right acts (4)

A

European convention on human rights, Scotland Act, Human rights act, Universal declaration of human rights (UN), Convention on the rights of persons with disabilities

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5
Q

Involuntary treatment - ethical criticisms (4)

A

non-maleficence
autonomy (liberty)
paternalism - ignores patients views
Non-discrimination (physical vs mental illness)

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6
Q

Involuntary treatment - ethical justifications (4)

A

Beneficence (including reducing risk)
Autonomy (may promote reasoned autonomy)
Right to treatment
Paternalism

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7
Q

Mental health act in scotland

A

Mental health (care and treatment Scotland) - 2003 modified in 2015

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8
Q

Why do we have mental health law

A

power to provide compulsory care and treatment for those with disorder

  • rights and safeguards to ensure powers are used correctly
  • wide range of services for people with mental health disorder
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9
Q

What legislation can also be used for someones liberty and involuntary treatment

A

Public health Act

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10
Q

Mental health care and treatment Scotland act - main principles

A
  • non discrimination
  • Equality
  • respect for diversity
  • Reciprocity
  • informal care
  • participation
  • respect for carers
  • benefit
  • child welfare
  • least restrictive alternative
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11
Q

Mental disorder is defined as

A

any mental illness, personality disorder, learning difficulty however caused or manifested

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12
Q

Don’t have a mental disorder based on these factors alone

A

Sexual orientation or deviancy
transsexulism, transvestism,
dependent on alcohol or drugs
behaviour that causes harassment, alarm or distress to another person

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13
Q

Name some important legislation acts (5)

A 
Children (scotland act) 1995
criminal procedure act 1995
The human rights act 1998
Adults with incapacity act 2000
Adult support and protection 2007
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14
Q

MH (C&T) (S) act - powers in it, whats it determined by?

A

civil
can detain, assess and treat
approved med practitioner, mental health officer, court

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15
Q

Who can be detained?

A

anybody

if under 18 - need child specialist

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16
Q

Main pieces of legislation that would be looked at? (4)

A

emergency detention certificate (EDC)
short-term detention certificate (STDC)
compulsory treatment disorder (CTO)
nurses holding power

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17
Q

The EDC - describe

A 
up to 72 hours
transfer to a psychiatric hospital 
- FULLY registered practitioner 
- no right to appeal for the patient 
- likely the patient has a MD, risk to self or others
- assessment and emergency treatment
18
Q

The (STDC) - describe

A 
28 days
must be an AMP - within 24 hours 
MHO 
The named person is consulted
Assessment and treatment
PATIENT CAN APPEAL
19
Q

Criteria for STDC? (5)

A
  • patient has MD
  • ability to make decisions is impaired as a result of MD
  • A significant risk to health, safety and welfare of patient or another person if they were not detained in hospital
  • need to be in hospital to determine treatment
  • certificate is necessary
20
Q

Compulsory treatment order - features

A 
up to 6 months for first one
- application by a MHO to the MHTS
Two medical reports - GP AND AMP
- proposed care plan - criteria the same as STDC
- COMMUNITY or HOSPITAL
21
Q

What is SIDMA

A

significant impairment of decision making ability about medical treatment for medical disorder - CAPACITY TEST

22
Q

Features of SIDMA (5)

A 
lack of insight
Cog impairment 
presence of psychosis 
severe depressive symptoms
learning disability
23
Q

what body considers applications and appeals around the mental health act

A

mental health tribunal

24
Q

police powers under act (2)

A

removal

detain and asssess

25
Q

Adults with incapacity act 2000 - what does incapable mean (5)

A

of action, making decisions, communicating decisions, understanding decisions or retaining the memory of decisions

26
Q

Capacity is assumed to be present unless? it is…

A

proven otherwise

situation specific

27
Q

Principles of the AWIA?

A

take in past and present wishes of patient - account taken of relatives/carers/attorneys

  • intervention must benefit the adult
  • leant restriction in relation to their freedom as possible
28
Q

What do we do to assess capacity ? (5) - gather info

A
  • evidence from court or case record
  • carers or fam members to give history
  • do they have power of attorney
  • any previous assessments
  • any prev stated views
29
Q

What do we do to assess capacity - clinical assessment

A

CURD

communication, understanding, retention of info, decision

30
Q

clinical assessment - communication (7)

A 
can they communicate?
sign language
hearing aids
written communication 
Makaton
Braille
Speech and language therapy assessment
31
Q

clinical assessment - understanding (4)

A

adequate info
pros and cons
ability to weigh the evidence
discussed the important risks

32
Q

clinical assessment - retention (2)

A

what did i want you to do?

can you explain it to me?

33
Q

clinical assessment - decision (2)

A

is it clear what the decision is

is it consistent

34
Q

Areas of the incapacity act? (3)

A

Property
Welfare
Financial

35
Q

Powers of the incapacity act?

A

intervention order - one off - application to court

guardianship order - doctors, MHO,

36
Q

the incapacity act does not authorise?

A
  • the use or force or detention - unless immediately necessary
  • action that would be inconsistent by a court
  • placing an adult in hospital for treatment against their will
37
Q

Adult protection deals with

A

harm inflicted by others, self harm and neglect

38
Q

What is the 3 point test of an adult that is at risk

A
  • unable to safeguard their own well-being, property rights or other harm
  • at risk of harm
  • affected by disability, mental disorder, illness or physical mental wellbeing
39
Q

Adult protection - what is risk defined as

A

another persons conduct is likely to cause the adult harm

- the adult is engaging in conduct that is likely to cause self harm

40
Q

Adult protection - what is harm defined as (4)

A

conduct which causes:

physical harms, psychological harms, unlawful conduct, self harm

41
Q

What do you do if you suspect an adult at risk?

A

speak to a senior
document concerns
report to relevant local authority

Year 3: Block 1: Medical Ethics (12 decks)

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